Development and validation of the postpartum sleep quality scale

Background: Postpartum sleep disorders are a significant problem for postnatal women. Although factors predisposing postnatal women to sleep disorders have been identified, few sleep quality assessment instruments adequately address these factors. Purpose: This study aimed to develop a Postpartum Sleep Quality Scale (PSQS) and test its psychometric properties. Methods: Sixteen PSQS items were generated from clinical practice, a literature review, and expert recommendations. Two hundred two postpartum women were recruited from a medical center and an obstetric clinic in southern Taiwan in 2010Y2011 to assess the internal consistency, testYretest reliability, construct validity, and convergent validity of the developed PSQS. Results: Item analysis removed two of the initial PSQS items. The resultant 14-item PSQS showed good internal consistency (! = .81) and acceptable 5-day testYretest reliability (r = .81). Construct validity was confirmed using exploratory factor analysis, which extracted and defined "Infant night care-related daytime dysfunction" and "Physical symptomsrelated sleep inefficiency" as the two main categories of postpartum sleep quality. These two factors explained 44.49% of total variance, with factor loadings between .43 and .76. Significant correlation (r = .67) with the Pittsburgh Sleep Quality Index showed convergent validity. Conclusion: The 14-item PSQS is a reliable, valid, and useful scale for measuring postpartum sleep quality and examining intervention protocols in Taiwanese postpartum women with sleep disturbance.